• INTRODUCTION
    • Arthroscopic glenoid reconstruction using a tricortical iliac crest bone graft is performed to anatomically reconstruct the glenoid and reestablish glenohumeral stability in patients with chronic anteroinferior shoulder instability and substantial osseous defects1-3.
  • STEP 1 PATIENT POSITIONING
    • Place the patient in the lateral decubitus position and prepare the arm and ipsilateral iliac crest.
  • STEP 2 DIAGNOSTIC ARTHROSCOPY AND PORTAL PLACEMENT
    • Perform a diagnostic arthroscopy via the posterior portal and establish an anteroinferior, an anterosuperior, and a deep anteroinferior portal.
  • STEP 3 CAPSULOLABRAL COMPLEX RELEASE AND SCAPULAR NECK PREPARATION
    • Depending on the pathology and morphology of the defect, release the capsulolabral complex from the scapular neck and prepare the glenoid rim and scapular neck with a motorized burr to ensure adequate osseous healing.
  • STEP 4 HARVESTING AND PREPARATION OF THE ILIAC CREST BONE BLOCK
    • Harvest an autologous tricortical iliac crest bone block from the ipsilateral side and contour it appropriately for an anatomic reconstruction of the glenoid.
  • STEP 5 GRAFT INSERTION AND POSITIONING
    • Enlarge the passage for the graft through the rotator interval, insert the bone block, and position it anatomically at the scapular neck.
  • STEP 6 GRAFT FIXATION
    • With the aid of a drill sleeve, temporarily stabilize the graft using Kirschner wires and then definitively attach it to the scapular neck using 2 Bio-Compression screws.
  • STEP 7 CAPSULOLABRAL REPAIR
    • Reattach the capsulolabral complex to the original glenoid, inferior and superior to the bone block, using 2 knotless suture anchors to complete the anatomic reconstruction of the glenoid.
  • STEP 8 REHABILITATION AND POSTOPERATIVE TREATMENT
    • Immobilize the arm for 6 weeks postoperatively and limit flexion and external rotation during this time period.
  • RESULTS
    • Fifteen patients with a mean age of 31.4 years (range, 17 to 49 years) with anteroinferior glenohumeral instability and substantial glenoid defects underwent arthroscopic iliac crest bone-grafting and were prospectively evaluated for an average period of 20.6 months (range, 12 to 65 months)12.